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Volume 13 No. 11
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Accepted Papers

Scientific Investigations

Prevalence of Cardiac Arrhythmias in Asian Patients With Obstructive Sleep Apnea: A Singapore Sleep Center Experience

Wei Li Neo, MRCS, MBBS1; Adele C.W. Ng, MBBS1; Mahalakshmi Rangabashyam, MBBS1; Ying Hao, PhD2; Kah Leng Ho, MRCP, MBBS3; Siti Raudha Binte Senin4; Song Tar Toh, FAMS, MMed1,4,5
1Department of Otolaryngology, Singapore General Hospital, Singapore; 2Health Services Research Unit, Division of Medicine, Singapore General Hospital, Singapore; 3National Heart Centre, Singapore General Hospital, Singapore; 4Sleep Disorder Unit, Singapore General Hospital, Singapore; 5Singhealth Duke-NUS Sleep Centre, Singapore

Study Objectives:

Obstructive sleep apnea (OSA) is associated with increased cardiovascular morbidity and mortality. Cardiac arrhythmias are common in patients with OSA. However, the prevalence and significance of cardiac arrhythmias in Asian patients with OSA are not well studied. The aim of this study is to determine the prevalence of cardiac arrhythmias in patients with OSA in Singapore and to evaluate possible factors that may predispose patients with OSA to arrhythmias.


A retrospective study of 2,019 patients was carried out from January 2011 to December 2012 at a sleep center in a tertiary medical center. Of the population, 1,457 patients were found to have OSA and 144 patients were found to have cardiac arrhythmias. Data collected included patient demographics, comorbidities, and polysomnogram parameters.


The prevalence of cardiac arrhythmias in our OSA population is 8.0%, compared to that of primary snorers at 4.8% (P = .015). The univariate analysis revealed that older age, higher body mass index, comorbidities, and severity of OSA, including apnea-hypopnea index (AHI), lowest oxygen saturation (LSAT) and hypoxic time were correlated with a higher prevalence of cardiac arrhythmias (P < .05). However, the multivariate analysis showed that only age and body mass index were significantly correlated with arrhythmias. AHI, LSAT, and hypoxic time were no longer statistically significant.


Our study demonstrated that cardiac arrhythmias are common in patients with OSA in Singapore. It also suggests that given the different demographics of our population, ethnicity may play a significant role in the development of cardiovascular disease among patients with OSA.


A commentary on this article appears in this issue on page 1229.


Neo WL, Ng AC, Rangabashyam M, Hao Y, Ho KL, Senin SR, Toh ST. Prevalence of cardiac arrhythmias in Asian patients with obstructive sleep apnea: a Singapore sleep center experience. J Clin Sleep Med. 2017;13(11):1265–1271.

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